학생반응으로 살펴본 문제바탕학습 교육과정의 질적 평가

김주희(Ju-Hui Kim),김지영(Ji Young Kim),손희정(Hee Jung Son),최윤호(Yoon-Ho Choi),홍경표(Kyung-Pyo Hong),안병헌(Byung-Heon Ahn),엄대용(Dae-Yong Uhm),진영은(Young Eun Chin),서정돈(Jung-Don Seo) 한국의학교육학회 2004 Korean journal of medical education Vol.16 No.2

Purpose: Recently established in 1997, Sungkyunkwan University School of Medicine was the first medical school in Korea to adopt problem-based learning (PBL) as a core curriculum from the very beginning. The purpose of this study was to evaluate the PBL curriculum from the viewpoint of the medical students. Methods: This study used a qualitative approach to understand students perceptions of the positive aspects of PBL. A total of 22 second-year medical students at Sungkynkwan medical school were surveyed. Student perceptions were obtained from questionnaire and face-to-face interviews. The interview was designed to evoke more personal and in-depth responses. Results: Students perceptions of the effects of PBL were found to be very favorable. Most students showed positive responses on the issues of more active learning attitude, self-directed learning, motivation to study, improved problem solving, and integrated learning. Conclusion: The results of this study demonstrated that the students had a good understanding of PBL and experienced its positive aspects of PBL approach. It might be concluded that PBL was successfully implemented into the curriculum and specific and expected effects of PBL accomplished.

문제바탕학습에서 튜터평가는 시험이 측정하는 것과는 다른 학습의 양상을 측정하고 있는가?

김지영(Ji Young Kim),손희정(Hee Jung Son),김주희(Ju Hui Kim),홍경표(Kyung Pyo Hong) 한국의학교육학회 2005 Korean journal of medical education Vol.17 No.1

Purpose: This study was aimed to examine whether tutor evaluation in the PBL course assesses different aspects of learning from what written examination assesses. Methods: 89 medical students were assessed by Self-Directed Learning Readiness Scale (SDLRS) and Learning Orientation Scale (LOS) in March 2004. Their tutor evaluation and written examination scores in the 1st semester of 2004 PBL units were collected in August 2004. Data analyses were conducted using t-test, correlation analysis, and linear regression. Results: SDLRS scores were significantly correlated with tutor evaluation scores, but not with written examination scores. Both schoolwork orientation and academic orientation scores on LOS were significantly associated with tutor evaluation and written examination scores. Tutor evaluation scores were explained significantly by all predictors, such as SDLRS, schoolwork orientation, and academic orientation scores. However, written examination scores were explained significantly by academic orientation only. Conclusions: Tutor evaluation in the PBL assessed student self-directed learning readiness and academic orientation, but written examination did not. The findings show a crucial possibility that tutor evaluation may overcome shortcomings of the written examination.

무증상 성인에서 헬리코박터 파일로리 감염과 다양한 전신 염증 표지자의 연관성 결여

김태준 ( Tae Jun Kim ),표정의 ( Jeung Hui Pyo ),이혁 ( Hyuk Lee ),백선영 ( Sun-young Baek ),안수현 ( Soo Hyun Ahn ),민양원 ( Yang Won Min ),민병훈 ( Byung-hoon Min ),이준행 ( Jun Haeng Lee ),손희정 ( Hee Jung Son ),이풍렬 ( Poong 대한소화기학회 2018 대한소화기학회지 Vol.72 No.1

Background/Aims: Helicobacter pylori (H. pylori) infection has been known to cause various extra-gastric diseases, which may be mediated by an increase in systemic inflammation. Thus, we examined the association between H. pylori infection and various markers of systemic inflammation in a large sample of asymptomatic adults. Methods: Cross-sectional data were obtained from 17,028 adults who completed routine health check-ups. H. pylori infection status was determined using a serum immunoglobulin G test, and systemic inflammation was assessed using the C-reactive protein (CRP) levels, neutrophil/lymphocyte ratio (NLR), and platelet/lymphocyte ratio (PLR). Results: Multiple linear regression model-adjusted for potential confounders-revealed that H. pylori infection was not associated with CRP levels (coefficient: -0.012, 95% confidence interval [CI]: -0.037, 0.012, p=0.319), NLR (coefficient: 0.055, 95% CI: -0.027, 0.138, p=0.192), or PLR (coefficient: 1.798, 95% CI: -1.979, 5.574, p=0.351). In a multivariable logistic regression model, H. pylori infection was not associated with the risk of CRP levels being elevated to ≥0.1 mg/dL (odds ratio: 0.96, 95% CI: 0.81, 1.08) or ≥0.3 mg/dL (odds ratio: 1.02, 95% CI: 0.84, 1.19). In the multivariable model, CRP levels elevated to ≥0.1 mg/dL were significantly associated with body mass index, current smoking status, hypertension, and diabetes mellitus. Regular exercise and high-density lipoprotein cholesterol were factors that minimized the elevation of CRP levels. Conclusions: Chronic infection with H. pylori was not associated with various inflammatory markers. Further investigation is needed to clarify the interaction between H. pylori infection, systemic inflammation, and extra-gastric disease. (Korean J Gastroenterol 2018;72:21-27)

근감소증이 미란성 식도염에 미치는 영향

허찬미 ( Chan Mi Heo ),김태준 ( Tae Jun Kim ),이혁 ( Hyuk Lee ),표정의 ( Jeung Hui Pyo ),민양원 ( Yang Won Min ),민병훈 ( Byung-hoon Min ),이준행 ( Jun Haeng Lee ),손희정 ( Hee Jung Son ),백선영 ( Sun-young Baek ),김경아 ( Kyunga 대한소화기학회 2020 대한소화기학회지 Vol.75 No.3

목적: 비만은 미란성 식도염(erosive esophagitis) 발생의 위험인자로 알려져 있으나 근감소증(sarcopenia) 및 비만과 미란성 식도염의 연관성은 아직 알려진 바가 없다. 따라서 본 연구에서는 무증상 남녀에서 일반 비만, 근감소증(sarcopenia), 근감소성 비만(sarcopenic obesity)과 미란성 식도염과의 연관성에 대하여 알아보고자 하였다. 대상 및 방법: 본 연구는 단면적 연구(cross-sectional study) 로써, 2006년 8월부터 2011년 12월까지 삼성서울병원에서 건강검진으로 상부위장관 내시경을 시행한 32,762명을 대상으로 하였다. 근감소증의 정의는 사지 근육량(ASM)을 체중으로 나누어 골격근 질량지수(skeletal muscle mass index: ASM [kg]/체중[kg]×100)를 구하고, 이 값을 젊은 성인 참조군(reference group)의 표준값의 2표준편차 이하인 경우로 정의하였다. 결과: 비만과 근육 감소 정도에 따라 정상군, 일반 비만군, 근감소증군, 근감소성 비만군 이렇게 네 군으로 나누어 분석하였다. 다변량 모형(multivariable model)으로 분석하여 보정교차비(adjusted OR)를 구한 결과, 일반 비만군 1.35 (95% CI 1.22-1.49), 근감소증군 2.12 (95% CI 1.40-3.19), 근감소성 비만군 1.54 (95% CI 1.27-1.87)이 정상군에 비하여 미란성 식도염 발생 위험이 높게 나타났다. 근감소증군과 근감소성 비만군의 미란성 식도염 발생 위험을 일반 비만군과 비교하였을 때, 교차비(ORs)는 각각 1.63 (95% CI 1.08-2.47), 1.22 (95% CI 1.01-1.46)로 일반 비만군에 비하여 높았다. 용량-반응분석에서 근육량 감소 정도는 미란성 식도염의 중증정도와 연관되어 근육량 감소가 심할수록 LA-B 이상 및 LA-C 미란성 식도염 소견을 보였다. 결론: 근감소증은 비만 여부와 상관없이 미란성 식도염의 발생 위험을 증가시키는 위험인자라는 것을 확인하였다. Background/Aims: An association between obesity and erosive esophagitis has been reported, but the effects of sarcopenia and obesity on erosive esophagitis are unknown. This study examined the relationship between obesity, sarcopenia, sarcopenic obe­sity, and erosive esophagitis in a large population of asymptomatic men and women. Methods: This study analyzed 32,762 subjects who underwent a comprehensive health check-up, which included upper gastro­intestinal endoscopy, from August 2006 to December 2011 by a cross-sectional study. Sarcopenia was defined as a decrease in the appendicular skeletal muscle mass (ASM)/body weight value of two SD or more below the normal means for a younger refer­ence group. Results: The study was carried out on four groups according to obesity and sarcopenic status: normal, obesity, sarcopenic, and sarcopenic obese group. In a multivariable model, the risk of erosive esophagitis was higher in the obese (adjusted OR [aOR] 1.35, 95% CI 1.22-1.49), sarcopenic (aOR 2.12, 95% CI 1.40-3.19), and sarcopenic obese groups (aOR 1.54, 95% CI 1.27-1.87) than in the normal group. The risk of erosive esophagitis was higher in the sarcopenic and sarcopenic obese groups than the obese group; the ORs were 1.63 (95% CI 1.08-2.47) and 1.22 (95% CI 1.01-1.46), respectively. In dose-response analysis, in­creasing sarcopenia severity showed a positive and graded relationship with the overall, Los Angeles (LA)-B or higher grade, and LA-C erosive esophagitis. Conclusions: This study suggests that sarcopenia is strongly and progressively associated with erosive esophagitis.

노화와 일회 지구성 운동이 골격근 내 mTOR, 4E-BP1, p70S6K 및 AMPK 발현에 미치는 영향

어수주(Eo Su-Ju),권형태(Kwon Hyeong-Tae),선주상(Shan Zhou-Xiang),채정훈(Chae Jung-Hun),김효식(Kim Hyo-Sik),손희정(Son Hui-Jung),김효정(Kim Hyo-Iung),김창근(Kim Chang-Keun) 한국체육과학회 2011 한국체육과학회지 Vol.20 No.3

We determined acute endurance exercise on mTOR signaling responses in aging skeletal muscle(soleus; SOL, extensor digitorium longus; EDL). Total 32 Sprague-Dawley rats were divided into two groups by age; young group(YG; 20wk; n=16) or old group(OG; 72wk; n=16). Each experimental group was further allocated two subgroups; Exercise(EX; n=8), Control(CON; n=8) group. All animals in exercise group performed one bout of 3hr endurance swimming exercise (30min×6bouts). The phosphorylation of mammalian target of rapamycin(mTOR) and p70 ribosomal S6 kinase(p70S6K) were significantly increased in 20wk(YG) soleus (p<.05). However, the phosphorylation of mTOR and eukaryotic initiation of factor 4E binding protein 1(4EBP1) were significantly decreased in 72wk(OG) muscles(p<.05) after endurance acute swimming exercise. The phosphorylation state of AMPK was significantly increased in 20wk(YG) muscles(p<.05) and 72wk soleus(p<.01) after exercise. The results suggest that a bout endurance exercise was increased AMPK activity but inhibited mTOR and 4E-BP1 phosphorylation in aging slow-twitch muscle.